Individual
MADISON LANE WELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1211 E BROADWAY, COLUMBIA, MO 65201
(573) 442-2211
Mailing address
3301 FAIRWAY DR, HIGHLAND, IL 62249-2804
(618) 792-8102
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/16/2025
Last updated
12/16/2025
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